AUTOTRANSPLANTATION OF THIRD MOLARS WITH OR WITHOUT IMMATURE ROOTS: A CASE SERIES WITH 3-YEAR FOLLOW-UP

PURPOSE. To evaluate the outcome of autotransplantation with third molars with or without complete root formation to replace irrecoverable teeth. MATERIALS AND METHODS. This study was designed as a case series. Unrecoverable teeth were extracted atraumatically. Third molars were extracted and positioned in the recipient site. Transplanted teeth were fixed with x-shaped sutures suspended above the occlusal surface or were splinted to the adjacent teeth and removed from occlusion. Teeth with immature roots were not endodontically treated to allow apex formation, whereas teeth with completely formed roots were endodontically treated three weeks later. Outcome measures were tooth loss and complications. Vitality tests were also performed on non-endodontically treated teeth. All patients were followed-up for three years after tooth transplant. RESULTS. Fifteen patients received 17 autotransplanted teeth, 10 with completely and seven with incompletely formed roots. Three years afterwards, no patient had dropped out. Only one transplanted tooth, with a mature root, failed, specifically after three months with compromised periodontal healing. No complications, including infection, inflammation or root resorption, were observed. However, ankylosis was radiographically visible in four mature teeth with completely formed roots at transplant. All teeth transplanted with immature roots maintained their vitality. CONCLUSIONS. Within the limitations of the present case series, autotransplantation, in particular of third molars with immature roots, could be a valid alternative to other therapies in selected patients.